Managing a COVID-Positive Health-Care Worker with Recent Suicide Attempt Through Telepsychiatry

Abstract

COVID-19 pandemic has emerged as a major problem for the health-care workers (HCWs). Many HCWs are facing adverse psychological outcomes, during the COVID pandemic. HCWs are not only expected to carry out duties in COVID areas but are also expected to stay in isolation during the period of quarantine. Various models have been proposed to address the psychological issues in HCWs using telepsychiatry. However, there are no clear-cut guidelines, for managing people with suicidal behavior. In this report we present a HCW, diagnosed with recurrent depressive disorder, current episode severe depression without psychotic symptoms, who attempted self-harm and was shortly diagnosed with COVID-19 infection leading her to getting admitted in the COVID-19 ward. She was managed with supportive psychotherapy during her COVID ward stay through telepsychiatry. We discuss the challenges faced and how these were handled.

Guiding future research on psychological interventions in people with COVID-19 and post COVID syndrome and comorbid emotional disorders based on a systematic review

“…Most of the studies had been conducted in China ( n = 15) ( 30 , 33 , 34 , 45 , 50 , 52–55 , 63 , 64 , 66–69 ), Iran ( n = 6) ( 38 , 47 , 48 , 58 , 61 , 62 ), Italy ( n = 5) ( 29 , 31 , 41 , 44 , 57 ), India ( n = 4) ( 36 , 46 , 56 , 59 ), United States ( n = 2) ( 28 , 35 ), and Korea ( n = 2) ( 49 , 65 ). The remaining studies had been developed in Saudi Arabia ( n = 1) ( 27 ), Nigeria ( n = 1) ( 32 ), Indonesia ( n = 1) ( 39 ), France ( n = 1) ( 42 ), Turkey ( n = 1) ( 43 ), Thailand ( n = 1) ( 51 ), Latvia ( n = 1) ( 40 ), Ghana ( n = 1) ( 37 ), and Poland ( n = 1) ( 60 ).…”

“…Regarding emotional disorders or symptoms addressed, the vast majority of studies were focused on depressive symptoms alone ( 30 ) or combined with anxiety ( n = 15) ( 33 , 34 , 40–42 , 44 , 47 , 48 , 50–52 , 55–57 , 60 ), panic attacks ( n = 6) ( 59 , 62 , 64 , 66–68 ), suicidal ideation or self-harming attempts ( n = 2) ( 36 , 37 ) or post-traumatic stress disorder (PTSD) ( n = 1) ( 38 ). On the other hand, six studies were focused on patients who presented with anxiety symptoms alone ( 43 , 46 , 53 , 54 , 58 , 61 ) or combined it with panic attacks ( 29 , 35 ).…”

“…The interventions with less representation were those based on music therapy ( 39 , 40 ); compassion ( 48 ); positive psychology with hypnosis and Ericksonian principles ( 60 , 69 ), narrative exposure therapy ( 45 ), EMDR ( 31 , 42 ) and imagination ( 58 ). Four case studies ( 30 , 32 , 35 , 36 ) and two pre-post studies without control group ( 63 , 65 ) did not provide information about the type of psychotherapy that was applied. One study ( 37 ) described two different psychological programs, one of them based on CBT and the other focused on social support, positive recovery and relaxation training.…”

“…The frequency of sessions also showed great variability. Some studies offered daily ( 36 , 43 , 52 , 61 ) or weekly sessions ( 28 , 31 ) while others proposed 2–3 sessions per week ( 44 , 48 , 57 , 67 ). Again, some inconclusive results were found in the sessions duration, which ranged from 5–10 min ( 46 , 47 , 55 , 56 ) to 60–90 min ( 44 , 45 , 48 ) ( Tables 1 , 2 ).…”

“…Other interventions used technology to provide the entire intervention. For example, seven studies used computerized programs which required the use of Internet-based solutions ( 45 , 55 , 57 , 64 ) or videoconferencing ( 29 , 36 , 41 ). Four programs used group social messaging platforms ( 51 , 54 , 61 , 68 ) and three studies used phone calls ( 35 , 49 , 65 ).…”